Obama Camp Has Many Ties to Wife's Employer

David Axelrod, right, worked for the University of Chicago Medical Center.
David Axelrod, right, worked for the University of Chicago Medical Center. (By Nancy Stone -- Chicago Tribune)
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By Joe Stephens
Washington Post Staff Writer
Friday, August 22, 2008

A few years ago, executives at the prestigious University of Chicago Medical Center were concerned that an increasing number of patients were arriving at their emergency room with what the executives considered to be non-urgent complaints. The visits were costly to the hospital, and many of the patients, coming from the surrounding South Side neighborhood, were poor and uninsured.

Michelle Obama, an executive at the medical center, launched an innovative program to steer the patients to existing neighborhood clinics to deal with their health needs.

That effort, in time, inspired a broader program the hospital now calls its Urban Health Initiative. To ensure community support, Michelle Obama and others in late 2006 recommended that the hospital hire the firm of David Axelrod, who a few months later became the chief strategist for Barack Obama's presidential campaign.

Axelrod's firm recommended an aggressive promotional effort modeled on a political campaign -- appoint a campaign manager, conduct focus groups, target messages to specific constituencies, then recruit religious leaders and other third-party "validators." They, in turn, would write and submit opinion pieces to Chicago publications.

One key recommendation from Axelrod's firm: "Respond quickly to opposition activity."

The medical center's initiative provides a window into the close relationship between the Obamas, their associates at the University of Chicago and Axelrod, the strategist most central to Barack Obama's rise. It also illustrates how that circle, and particularly Michelle, dealt with an intractable social problem that confronts many urban areas: How much care should large, nonprofit hospitals offer the poor in return for tax-exempt status?

The medical center markets its initiative as an effort to improve patient health for the poor and at the same time free its resources for emergencies and complicated procedures. The Urban Health Initiative also could save the hospital substantial amounts of money, by removing the nonpaying poor patients from its emergency room.

"An ER visit for something that's not an emergency costs the medical center $1,200," said Kelly Sullivan, a hospital spokeswoman. "That's sucking up dollars in health care that we don't all have to just blow through carelessly.

"Michelle inspired us . . . to step back and take a holistic approach to this problem."

Those involved in the effort in Chicago say that they are hopeful but that it is too soon to judge its success.

Michelle Obama and Axelrod did not respond to requests for an interview about the initiative. Axelrod's partner, Eric Sedler, confirmed his firm did the work but declined to discuss specifics. Hospital executives declined to say how much Axelrod's firm was paid.

Howard Peters of the nonprofit Illinois Hospital Association praised the medical center's efforts, saying the ER is not the place to provide patients with primary medical care.

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